General Approach to a Wide QRS Complex

Roberto De Ponti, Giuseppe Bagliani, Luigi Padeletti, Andrea Natale

Research output: Contribution to journalReview articlepeer-review


Wide QRS complex is present when the normal activation pattern is modified by various mechanisms and clinical conditions. Correct interpretation is crucial for appropriate decision making. When approaching an electrocardiogram (ECG) with wide complex tachycardia, one must differentiate between ventricular tachycardia and supraventricular tachycardia conducted with aberrancy. ECG criteria are used and algorithms developed to aid in differential diagnosis. They are based on finding ECG signs of ventriculoatrial dissociation and QRS morphologies inconsistent with classic bundle branch block. The conditions able to modify structurally the normal activation of the heart may alter spontaneous ventricular activation during supraventricular tachycardia, creating differential diagnosis problems.

Original languageEnglish
Pages (from-to)461-485
Number of pages25
JournalCardiac Electrophysiology Clinics
Issue number3
Publication statusPublished - Sep 1 2017


  • Aberrancy
  • QRS complex
  • Supraventricular tachycardia
  • Ventricular tachycardia
  • Wide complex tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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